Blood Patch, Post-Dural Puncture Headache
Conditions
Keywords
Post Dural puncture headache, Epidural blood patch, Chronic headache, Epidural analgesia, Obstetric anaesthesia
Brief summary
The purpose of this study is to identify possible links between conditions for carrying out a blood patch (BP) to treat accidental post dural puncture acute headache (PDPH) in the early post partum period and occurrence of chronic headaches at 1 and 6 months.
Detailed description
It is established that accidental dural puncture promotes the onset of chronic headaches in 25 to 60% of cases but the risk factors for the occurrence of this event are not known. To identify those risk factors, the investigators will analyze the initial conditions of the accidental breach, the initial manifestations of the PDPH, the methods of carrying out the BP and the patient data. In this study, the investigators will evaluate (phone questionnaire and score) incidence of chronic headaches at 1 month and 6 months after the realization of a blood patch, incidence of chronic low back pain, impact on daily life, incidence of late recurrences of PDPH, incidence of early and distant complications In case of failure of effectiveness of the first blood patch, the investigators will search for associated factors: patient data, mode of delivery, initial PDPH, conditions for carrying out the BP.
Interventions
OTHERQuestionnaires
Questionnaires by phone at 1 and 6 months after inclusion
Sponsors
Assistance Publique - Hôpitaux de Paris
URC-CIC Paris Descartes Necker Cochin
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age greater than or equal to 18 years old, * Vaginal delivery or caesarean section with epidural at the Port Royal maternity ward, * Collection of non-opposition after oral and written information,
Exclusion criteria
* Patient under curatorship or guardianship * Not speaking/understanding French * BP performed in another indication * Benefiting from the AME (state medical aid)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Description of the conditions of the accidental breach | Immediately after BloodPatch procedure | Data collection of diagnosis of the accidental breach : * noted with the needle, * intrathecal passage, * postpartum positional headaches, * intrathecal catheter |
| Time to onset | Immediately after BloodPatch procedure | Description of the initial manifestations of post dural puncture acute headache (PDPH) : nature of PDPH |
| Positional | Immediately after BloodPatch procedure | Description of the initial manifestations of post dural puncture acute headache (PDPH) : nature of PDPH |
| Neck pain | Immediately after BloodPatch procedure | Description of the initial manifestations of post dural puncture acute headache (PDPH) : nature of PDPH |
| Analog visual scale (AVS) | Immediately after BloodPatch procedure | Description of the initial manifestations of post dural puncture acute headache (PDPH) : nature of PDPH |
| Neurosensory disorders | Immediately after BloodPatch procedure | Description of the initial manifestations of post dural puncture acute headache (PDPH) : nature of PDPH |
| Completion time after childbirth | Immediately after BloodPatch procedure | Description of the methods of carrying out the BloodPatch (BP) |
| Volume injected | Immediately after BloodPatch procedure | Description of the methods of carrying out the BloodPatch (BP) |
| Height of puncture compared to the initial breach | Immediately after BloodPatch procedure | Description of the methods of carrying out the BloodPatch (BP) |
| Paresthesias | Immediately after BloodPatch procedure | Description of the methods of carrying out the BloodPatch (BP) |
| Adverse events | Immediately after BloodPatch procedure | Description of the methods of carrying out the BloodPatch (BP) |
| Duration of strict decubitus in the immediate afterglow | Immediately after BloodPatch procedure | Description of the methods of carrying out the BloodPatch (BP) |
| Age | Immediately after BloodPatch procedure | Patient data collection |
| Height | Immediately after BloodPatch procedure | Patient data collection |
| Weight | Immediately after BloodPatch procedure | Patient data collection |
| Parity | Immediately after BloodPatch procedure | Patient data collection |
| Mode of delivery | Immediately after BloodPatch procedure | Patient data collection |
| History of headaches or migraines before pregnancy | Immediately after BloodPatch procedure | Patient data collection |
| Initial treatment (before 1st BP) | Immediately after BloodPatch procedure | Patient data collection NSAIDs and analgesics, sphenopalatine ganglion block, ACTH, caffeine, other |
| Imaging | 1 month after last BloodPatch procedure | Patient data collection |
| Lumbar punction | 1 month after last BloodPatch procedure | Patient data collection |
| Other examinations if performed | 1 month after last BloodPatch procedure | Patient data collection |
| Complications during the initial postpartum stay | Immediately after BloodPatch procedure | Patient data collection |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients with chronic headaches | Month 1 | Score - phone questionnaire |
| Number of patients with chronic low back pain | Month 1 | Score - phone questionnaire |
| Modified Headache Impact Questionnaire (HIT) | Month 1 | Impact on daily life - Phone questionnaire - Headaches : "Yes/No" Low back pain, "never/rarely/from time to time/often/all the time" |
| Number of patients with late recurrence of typical post dural puncture acute headache (PDPH) | Month 1 | Score - phone questionnaire |
| Number of patients who have been rehospitalized | Month 1 | Score - phone questionnaire |
| Number of patients consulted for headaches | Month 1 | Score - phone questionnaire |
| Number of patients who received complementary treatments | Month 1 | Score - phone questionnaire |
| Patient data collection | Month 1 | In case of failure of efficacy of the 1st BP: patient data, mode of delivery, initial Post dural puncture acute headache (PDPH), conditions for carrying out the BP |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORCatherine FISCHER, MD
Cochin Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP)
Outcome results
None listed